【作者】 周慧蓉； 林晓萍；

【Author】 Huirong Zhou;Xiaoping Lin;Department of Stomatology,Shengjing Hospital of China Medical University;

【机构】 中国医科大学附属盛京医院口腔科；

【摘要】 在老年群体中,复发性阿弗他溃疡(recurrent aphthous ulcer,RAU)、口腔扁平苔藓、灼口综合征(burning mouth syndrome,BMS)等口腔黏膜疾病常由于病因与发病机制不明确,难以达到临床治愈。近年来,有学者认为RAU、BMS等口腔黏膜疾病可纳入心身疾病的范畴,精神心理因素对这些疾病的发生发展产生不同程度的影响。(1)文献收集与汇总:使用计算机检索PubMed、EMbase、中国知网(CNKI)等数据库口腔黏膜疾病与精神心理因素有关的论文,对口腔黏膜疾病与精神心理因素相关研究及可能的神经生物学机制进行尽可能全面地综述。(2)结果分析与解读:心理应激因素影响人体正常的神经内分泌免疫途径,导致下丘脑-垂体-肾上腺轴、交感-肾上腺髓质轴、自主神经、内分泌和免疫系统的过度激活或抑制,导致激素、细胞因子和蛋白质的分泌发生变化,从而影响细胞和体液免疫。这可能会导致相应的身体症状,并引发口腔黏膜疾病。此外,因口腔黏膜病损顽固且易复发的特性,患者长期处于压力下,易产生焦虑、抑郁等不良情绪,使口腔黏膜疾病进展加速。(3)疾病的诊疗与管理:在临床诊疗口腔黏膜疾病的过程中,口腔科医生除对症治疗外,必要时应与精神科医生共同制定多学科诊疗方案,针对个体的精神心理障碍进行干预,以提高口腔黏膜疾病的治愈率。更多还原

【Abstract】 In the elderly population,recurrentaphthousulcer(RAU),oral lichen planus,burningmouthsyndrome(BMS) and other oral mucosal diseases are often difficult to achieve clinical cure due to unclear etiology and pathogenesis.In recent years,some scholars believe that oral mucosal diseases such as RAU and BMS can be included in the category of psychosomatic diseases,and psychological factors have different degrees of influence on the occurrence and development of these diseases.(1) Literature collection and summary:Papers related to oral mucosal diseases and psychological factors were searched by computer in PubMed,EMbase,China Knowledge Network(CNKI),and the related research and possible neurobiological mechanisms of oral mucosal diseases and psychological factors were summarized as comprehensively as possible.(2) Analysis and interpretation of the results:Psychological stress factors affect the normal neuroendocrine immune pathway of human body,resulting in excessive activation or inhibition of hypothalamuspituitary-adrenal axis,sympathetic-adrenal medulla axis,autonomic nerve,endocrine and immune system,leading to changes in the secretion of hormones,cytokines and protein,thus affecting cellular and humoral immunity.This may lead to corresponding physical symptoms and cause oral mucosal diseases.In addition,due to the stubborn and easy-to-relapse characteristics of oral mucosal lesions,patients are under pressure for a long time,and are prone to anxiety,depression and other negative emotions,which accelerates the progress of oral mucosal diseases.(3) Diagnosis and management of diseases:In the process of clinical diagnosis and treatment of oral mucosal diseases,dentists should,in addition to symptomatic treatment,work out multidisciplinary diagnosis and treatment plans with psychiatrists when necessary,and intervene against individual mental and psychological disorders to improve the cure rate of oral mucosal diseases.更多还原